YWCA - WE 360° Jr. Registration Form

Please Note: This is a registration form to show your interest in the course. This course will take place from February 25th - May 11th, with meetings every Wednesday night. A mandatory orientation will take place on February 11th.

You will receive an email immediately after registration with more information.
YOUR NAME*

MS. / DR. ETC.FIRST NAMEMIDDLE / INITIALLAST NAMEJR. / III / ESQ / ETC.
YOUR EMAIL*
YOUR MAILING ADDRESS*

STREET ADDRESS OR PO BOX

Street Address Line 2

CITYSTATE

ZIP CODE
YOUR PHONE NUMBER*

AREA CODEPHONE NUMBER
DO YOU ALREADY HAVE A BUSINESS IDEA IN MIND THAT YOU'D LIKE TO START?*

I have a businessI do not have a business idea
YOUR INDUSTRY (FOR WE 360° JR. RECORDS ONLY)

BeautyConsultingEcommerceEducationFaith-based organizationFinancial services & insuranceFood & beverageHealthcareHospitalityHuman resources & trainingLogisticsPublic speakerReal estateRetailSales & marketingTechnologyOther
YOUR RACE (FOR WE 360° JR. RECORDS ONLY)*

American Indian/Alaskan NativeAsianBlack / African descent: having origins in Sub-Saharan AfricaHispanic / Latino / Latinx: identify as Hispanic or Latino with ties to Latin AmericaMiddle Eastern / North African: including the Middle East, North Africa, the Arab WorldNative Hawaiian or Other Pacific IslanderWhite / European descentIndigenous: Alaskan Native, First Nations, Native American, Native Hawaiian, SamoanMy race/ethnicity is not represented abovePrefer not to answer
YOUR AGE (FOR WE 360° RECORDS ONLY)*

18 (I'm out of high school)19202122232425
YOUR AGE (FOR WE 360° RECORDS ONLY)*

Under 1818-2425-3435-4950-6465+
YOUR GENDER (FOR WE 360° JR. RECORDS ONLY)*

FemaleMaleTrans female: assigned male at birthTrans male: assigned female at birthNon-binaryGender non-conformingMy gender identity is not represented abovePrefer not to answer
YOUR PREFERRED PRONOUN (FOR OUR RECORDS ONLY)*

He / him / his / himselfShe / her / her / herselfThey (singular) / them / their / themselvesEy / em / eir / eirselfSie / sie / hir / hirselfTey / ter / tem / terselfVe / ver / vis / verselfZie / zir / zirs / zirself
WERE YOU REFERRED BY ANOTHER YWCA?
IF YES, WHICH ONE?
COMMENTS (IF ANY)
YOUR DESIRED SESSION*
WE 360° JR. PRE-SURVEY
I CAN CLEARLY CONVEY MY BUSINESS CONCEPT*

Strongly agreeAgreeSomewhat agreeNeither agree nor disagreeSomewhat disagreeDisagreeStrongly disagree
I UNDERSTAND THE PURPOSE OF A BUSINESS PLAN*

Strongly agreeAgreeSomewhat agreeNeither agree nor disagreeSomewhat disagreeDisagreeStrongly disagree
I HAVE IDENTIFIED MY BUSINESS' TARGET AUDIENCE OR CUSTOMER GROUP*

Strongly agreeAgreeSomewhat agreeNeither agree nor disagreeSomewhat disagreeDisagreeStrongly disagree
I HAVE AN ANNUAL BUDGET AND REGULARLY REVIEW MY FINANCIALS*

Strongly agreeAgreeSomewhat agreeNeither agree nor disagreeSomewhat disagreeDisagreeStrongly disagree
I MANAGE MY FINANCES IN A MANNER CONSISTENT WITH A SUCCESSFUL BUSINESS*

Strongly agreeAgreeSomewhat agreeNeither agree nor disagreeSomewhat disagreeDisagreeStrongly disagree
MY MARKETING STRATEGY IS SUFFICIENT TO PROMOTE MY BUSINESS*

Strongly agreeAgreeSomewhat agreeNeither agree nor disagreeSomewhat disagreeDisagreeStrongly disagree
I HAVE CONFIDENCE IN MY PLAN FOR FUNDING MY BUSINESS*

Strongly agreeAgreeSomewhat agreeNeither agree nor disagreeSomewhat disagreeDisagreeStrongly disagree
I'VE COMPLETED ALL LOCAL / STATE / USA LEGAL FORMS NEEDED FOR MY BUSINESS*

Strongly agreeAgreeSomewhat agreeNeither agree nor disagreeSomewhat disagreeDisagreeStrongly disagree
I AM PLEASED WITH MY LAUNCH / RE-LAUNCH PLAN*

Strongly agreeAgreeSomewhat agreeNeither agree nor disagreeSomewhat disagreeDisagreeStrongly disagree
By typing your name below, you give us permission to share your image as a participant in this workshop course on our social media, website, and/or materials. Thank you!
YOUR SIGNATURE*
Should be Empty:

WE 360° JR. PRE-SURVEY